state-imposed legal limitations on the number of hours worked

							state-imposed legal limitations on the number of hours worked by physician residents are increas-
ingly common and encourage hospitals to use physician assistants to supply some of the services that
were being performed by a physician resident.
nurses in the hospital, a large number of nurses will be employed in home health, long-term, and am-
bulatory care (1998-99 Occupational Outlook Handbook, 1998).
                                         CAREER ADVANCEMENT

                Physician Assistants

. Physician assistants can advance their career by enhancing their clinical skills or by learning new
skills to qualify them to work in nonclinical areas. One way to further their clinical skills is through
physician-assistant residency programs. Physician-assistant residencies provide trainees with additional
clinical experience, usually for one year, in a specialty area. At the completion of the residency pro-
gram, physician assistants will usually earn a certificate. This expansion of their skills qualifies them for
more advanced positions. Some residency graduates earn a higher income than nonresidency physician
assistants, but this is certainly not a rule (Schafft & Cawley, 1987).
   Many physician assistants have not received this additional formal training and they function effec-
tively in various specialty areas (Schafit & Cawley, 1987). For example, most surgical physician assis-
tants have received their training on-the-job.
   Physician assistants can advance their clinical knowledge through the completion of continuing
medical education (CME). CME is provided by the American Academy of Physician Assistants
Association.
   Education in nonclinical areas can enhance a physician assistant's career also. For example, they
may pursue a master's degree in public health, education, or business. In most cases, physician assistants
who seek career advancement must usually seek education outside the clinical area in which they are
trained.
  Physician assistants can become active in national and state organizations so that they can be advo-
cates for the profession. Skills such as finance, organizational development, cost accounting, mar-
keting, and economics will help physician assistants advance their career in this area. "A physician
assistant who can combine clinical skills with administrative ability will be a valuable asset to the
corporate world and the health planning community" (Schafft & Cawley, 1987. p. 151).

                Nurse Practitioners

  Nurse practitioners can advance their career by enhancing their clinical skills or by learning new
skills to qualify them to work in nonclinical areas.
  Nurse practitioners can enhance their skills by attending seminars, completing a post-master's
certificate program, or completing a doctorate in a nursing program.
  In addition to the traditional employment opportunities for nurse practitioners, there are many
nonclinical areas in which nurse practitioners can seek employment. These include, but are not limited
to, public health, editing nursing journals, case management, consulting, international nursing,
management, research, administration, and teaching. Some of these positions, such as teaching,
require an advanced degree.
  In 1996, about 5% of registered nurses were enrolled in a doctoral program (U.S. Department of
Health and Human Services, 1996), Some nurse practitioners complete doctorate programs in
non-nursing areas such as public health or education. According to the U.S. Department of Health
and Human Services, nurses with post-RN doctoral degrees mainly work in research and education. Of
the nurses with doctoral degrees, 37.5% of them work in education, 34% in research, 12% in clinical
practice, and the remaining work in areas such as public health and supervision or administration
(U.S. Department of Health and Human Services, 1996).
The Advisor
Fall 1998/Vol. 19